Vomiting In Children - When Should You Be Really Concerned?

Common as it may seem, vomiting is still considered abnormal. Check out our expert's views on what causes vomiting and when it should be a cause for concern.

By Dr Uppal Saurabh

Vomiting In Children - When Should You Be Really Concerned?

It is rather common for children to vomit. But most parents find it extremely disturbing as it is considered abnormal. Vomiting is one of the top five reasons why parents seek a paediatrician’s advice. While there may be several minor reasons for vomiting, it is important to monitor a child who is vomiting as it can be a sign of an underlying problem.

What is vomiting?

Vomiting is the forceful expulsion of stomach contents from the mouth. It is brought about by the contraction of the tummy and chest wall muscles. The matter that is expelled from the mouth is known as 'vomitus'. Vomitus often has a slight yellow tinge, which is caused by some of the stomach and intestinal juices expelled with it.

What causes vomiting?

The brain has a ‘vomiting centre’ that gets signals from nerves in the stomach or certain brain areas. The vomiting centre sends signals to the tummy muscles and diaphragm to contract, causing a person to vomit. Vomiting is usually a ‘protective reflex’ that functions as a means to remove irritating and harmful substances from the body.

Common causes of vomiting

  • The most common cause of vomiting in toddlers is viral gastroenteritis, commonly known as ’stomach flu’. This is a viral infection that can last anywhere from a few days to more than a week, and is usually accompanied by fever and loose stools.
  • Motion sickness is another common reason for vomiting. According to the US Centre for Disease Control and Prevention, about 50 per cent of children feel sick while travelling in cars or planes at some time or the other.
  • Food poisoning can also cause vomiting. It occurs when stale or contaminated food or water is consumed. The symptoms mimic viral gastroenteritis and could begin from anywhere within a few hours to a few days after eating contaminated food. If your child starts vomiting immediately after eating something, it may be due to spoilt food that could be toxic, and it is advisable to consult a doctor without delay.
  • Overfeeding or forceful feeding.
  • Some children also have trouble retaining food in their tummies. They throw up when they cough, cry or get too excited, or even if they see something that turns their stomach, if they eat or drink too much or run around after eating. This is rather common and should be considered normal.
  • Vomiting can also be just one symptom of a more serious infection. If your child has been well otherwise before he has vomited, there isn’t much to worry about. However, if he seems lethargic, is behaving abnormally or not eating or drinking much and is vomiting repeatedly, you need to be concerned about a serious infection. In this situation, consult your doctor immediately.
  • Infections in the urinary system, ears or appendix can also cause vomiting but this seldom occurs without other accompanying problematic signs.
  • Some long-term illnesses or digestive disorders, such as lactose intolerance, food allergies or celiac disease can cause chronic vomiting intermittently for months together.
  • A worrisome cause of repeated vomiting in children indicates a problem in the brain. It could be a migraine, a missed head injury or any mass in the brain. So continuous vomiting, especially if associated with a headache, should never be ignored.
  • Infants (less than 1 year of age) may regurgitate milk which is often confused with vomiting. This is a normal phenomenon in the first year of infancy.

What should be your immediate concern?

The immediate concern should be to prevent dehydration. Give your child small sips of water or shikanjvi or rice kanji every few minutes he is rehydrated and feeling better. If your baby is being breastfed, you can continue breastfeeding him.

How do you know if your child is dehydrated?

Signs of dehydration include:

• Passing urine less frequently than usual

• Dry mouth and tongue

• No tears when crying

• Lethargy and/or irritability

• Deep, rapid breathing

• Loose and wrinkly skin

When should you be concerned?

You should worry when there is:

1. Repeated vomiting

2. Vomiting with headache

3. Vomit is dark green or brown in colour

4. Vomiting is forceful (falls away from the child like a projectile)

5. Vomiting with unusual behaviour

6. Vomiting lasts more than a day

7. Vomiting in sleep

Consult a doctor immediately if one or more of these conditions persist.

To sum it up, you need not be alarmed every time your child vomits. The key is to know your child well enough so that you notice as soon as things seem unusually different.